Provider Demographics
NPI:1235791310
Name:MARS PREMIER CARE LLC
Entity Type:Organization
Organization Name:MARS PREMIER CARE LLC
Other - Org Name:MARS PREMIER CARE DAY HABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-204-1781
Mailing Address - Street 1:PO BOX 731
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-0731
Mailing Address - Country:US
Mailing Address - Phone:929-204-1781
Mailing Address - Fax:888-767-9772
Practice Address - Street 1:375 MCCARTER HWY STE 201
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-2562
Practice Address - Country:US
Practice Address - Phone:929-204-1781
Practice Address - Fax:888-767-9772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services